The earliest recorded usage of the term "macrobiotics" is found in the writings of Hippocrates. Translated literally, macro is the Greek word for "great" and bios is the word for "life." The term "macrobiotics" refers to a philosophy of working with the natural order of life. Philosophers and physicians from many parts of the world have used this term to signify living in harmony with nature and eating a simple, balanced diet to live to an active old age.

The modern practice of macrobiotics was started in the 1920s by a Japanese educator named George Ohsawa, said to have cured himself of a serious illness by changing to a simple diet of brown rice, miso soup, and sea vegetables.

Macrobiotics is a predominantly vegetarian, whole-foods diet that emphasizes whole grains (especially brown rice), vegetables, fruits, legumes, and seaweeds. Some proponents eat white meat or fish once or twice a week, while others eat no animal products whatsoever - an approach referred to as "vegan." Macrobiotic diets may be individualized based on factors such as climate, season, age, gender, activity, and health needs.

Studies have shown increased risk for various nutrient deficiencies. However, proponents argue that with judicious menu planning, most vegetarian diets can supply excellent nutrition. The most common supplementation is with dairy products.

The macrobiotic diet is low in saturated fat and high in phytoestrogens, which may help balance a woman's hormones during menopause, reduce symptoms of premenstrual syndrome, and prevent breast cancer and endometriosis.

Both plant-only and plant-based eating patterns have health benefits, most notably in reducing the risk of chronic, degenerative diseases.

Macrobiotics is one of the most popular lifestyle approaches to cancer. However, the evidence as to whether or not a macrobiotic diet can help in cancer is mixed and inconclusive. Overall, there has been little evidence on the effectiveness of a macrobiotic diet aside from case reports.

At the heart of macrobiotics are the concepts of yin and yang, which were identified in Taoist Chinese philosophy as two principles that complement each other as life unfolds.

Yin represents expansion, coolness, and passiveness while yang represents contraction, heat, and aggressiveness. In the macrobiotic view, the forces of yin and yang must be kept in balance to achieve good health.

Foods are classified into yin and yang categories according to their various properties and their effects on the body.

The tastes of foods (sour, bitter, sweet, pungent, salty) determine how they will interact with each other.

The food groups that have the least pronounced yin and yang qualities, grains and vegetables, are emphasized in macrobiotics. Eating these foods is thought to make it easier to achieve a more balanced condition within the natural order of life. Foods considered extremely yin or extremely yang are avoided. Food combining is planned to achieve a balance of tastes.

Western science has identified the high phytoestrogen content of a macrobiotic diet as a feature that may theoretically aid in reducing cancer risks.

A macrobiotic diet appears to promote hormonal conditions that are unfavorable to the development of breast cancer. This may help explain why women in cultures that favor a vegetarian diet are at a lower risk of breast cancer. However, research in this area is ambiguous, and there is insufficient data from clinical studies to support concrete recommendations.

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

GRADE *

There is evidence from one study suggesting that a macrobiotic diet might contribute to an improved ratio of HDL ("good" cholesterol) to LDL ("bad" cholesterol). However, more research is needed to explore whether such effects are reliable and meaningful.

C

The evidence is mixed as to whether or not a macrobiotic diet helps, hinders, or has no effect on cognitive functioning in children.

C

There is evidence that a macrobiotic diet may lead to reduced body size and obesity and increased leanness in preschool children compared to children on a normal diet. Studies are needed to determine whether or not these changes contribute to good health in children.

C

A macrobiotic diet has been advocated to preserve intestinal health. However, it apparently does not reduce the incidence of drug-resistant bacteria in the intestinal flora, nor infections caused by resistant strains in the gastrointestinal tract, compared to a diet with animal products.

D

* Key to grades

A: Strong scientific evidence for this useB: Good scientific evidence for this useC: Unclear scientific evidence for this useD: Fair scientific evidence for this use (it may not work)F: Strong scientific evidence against this use (it likley does not work)

Tradition / Theory
The below uses are based on tradition, scientific theories, or limited research. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. There may be other proposed uses that are not listed below.

Safety
Many complementary techniques are practiced by healthcare professionals with formal training, in accordance with the standards of national organizations. However, this is not universally the case, and adverse effects are possible. Due to limited research, in some cases only limited safety information is available.

Numerous studies indicate that a macrobiotic diet can lead to deficiencies of many nutrients. Reasons for these deficiencies include their unavailability in the food being consumed, their destruction during preparation of the food, their degradation over time from when the food is harvested to when it is consumed, or their delivery of the nutrient in a form the person cannot digest or absorb.

Children and pregnant/lactating women are at particular risk for deficiencies related to a macrobiotic diet.

Related health problems due to nutrient deficiency that have been observed include anemia, growth retardation or stagnation in infants and children, low birth weight, low energy, lower bone mass, rickets, and scurvy.

Some cancer patients using this approach may experience problems due to weight loss and difficulties in implementing the diet. More studies are needed to evaluate whether a macrobiotic diet is beneficial in cancer.

The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.